Advertisement

Prevalence of Asthma and Asthmatic Symptoms in Children in Relation to Environmental Factors —Epidemiological Studies in School Children in Taiyuan, China

  • Zhuo-Hui Zhao
  • Zhuan-Hua Wang
  • Zheng Zhang
  • D. Norbäck
  • G. Wieslander
Part of the Advanced Topics in Science and Technology in China book series (ATSTC)

Abstract

There has been a rapid increase in prevalence of asthma in Chinese children. However, the current level is still lower when compared to the prevalence in Western countries. Environmental factors might be associated with the increasing prevalence of children’s asthma and asthmatic symptoms in China. In this study, a cross-sectional survey was performed in 10 randomly selected schools involving 1993 children (mean age 13 years old) in urban areas in Taiyuan, China. Data on children’s asthma and asthmatic symptoms were collected by a questionnaire taken from the International Study on Asthma and Allergies in Childhood (ISAAC). Data on environmental exposure, including indoor and outdoor chemical air pollutants and indoor biological contamination in the settled dust, were quantitatively evaluated in the school environment. The results showed that the indoor school environment in urban areas in Taiyuan was contaminated with chemical air pollutants of outdoor origin (SO2, NO2, O3 and formaldehyde), and that the air pollutants were positively associated with children’s wheezing and daytime attacks of breathlessness. Different microbial components in the settled dust showed different effects regarding the prevalence of children’s respiratory symptoms, for example, muramic acid, a marker of gram positive bacteria, was negatively associated with children’s respiratory health, while ergosterol, a marker of fungi, showed positive associations. There was a low level of allergen contamination in the settled dust in the school environment and the detected airborne cat and dog allergens were not associated with any health parameters included in this study. In addition, environmental tobacco smoking (ETS) and emissions from new furniture in the home environment were risk factors for children’s respiratory symptoms. In conclusion, chemical air pollutants in schools may adversely affect children’s asthmatic symptoms while biological components resulted in more complex effects. This further research on different environmental factors and their potential interactions needs to be explored.

Keywords

Environmental Tobacco Smoking Muramic Acid Settle Dust Home Environmental Factor 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Asher, M.I., Keil, U., Anderson, H.R., et al. (1995). International Study of asthma and allergies in childhood (ISAAC): Rationale and methods. Eur Respir J, 8(3), 483–491.PubMedCrossRefGoogle Scholar
  2. Asher, M.I., Montefort, S., Bjorksten, B., et al. (2006). Worldwide time trends in the prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and eczema in childhood: ISAAC phases one and three repeat multicountry cross-sectional surveys. Lancet, 368(9537), 733–743.PubMedCrossRefGoogle Scholar
  3. Chauhan, A.J., Inskip, H.M., Linaker, C.H., et al. (2003). Personal exposure to nitrogen dioxide (NO2) and the severity of virus-induced asthma in children. Lancet, 361(9373), 1939–1944.PubMedCrossRefGoogle Scholar
  4. Chen, Y.Z. (2004). Comparative analysis of the state of asthma prevalence in children from two nation-wide surveys in 1990 and 2000. Zhonghua Jie He He Hu Xi Za Zhi, 27(2), 112–116 (in Chinese).PubMedGoogle Scholar
  5. Dong, G.H., Cao, Y., Ding, H.L., et al. (2007). Effects of environmental tobacco smoke on respiratory health of boys and girls from kindergarten: results from 15 districts of northern China. Indoor Air, 17(6), 475–483.PubMedGoogle Scholar
  6. Dong, G.H., Ma, Y.N., Ding, H.L., et al. (2009). Pets keepting atin home, parental atopy, asthma, and asthma-related symptoms in 12,910 elementary school children from northeast China. Indoor Air, 19(2), 166–173.PubMedCrossRefGoogle Scholar
  7. Douwes, J., Pearce, N. (2002). Asthma and the westernization ‘package’. Int J Epidemiol, 31(6), 1098–1102.PubMedCrossRefGoogle Scholar
  8. Emenius, G., Larsson, P.H., Wickman, M., et al. (2001). Dispersion of horse allergen in the ambient air, detected with sandwich ELISA. Allergy, 56(8), 771–774.PubMedCrossRefGoogle Scholar
  9. Gent, J.F., Triche, E.W., Holford, T.R., et al. (2003). Association of low-level ozone and fine particles with respiratory symptoms in children with asthma. JAMA, 290(14), 1859–1867.PubMedCrossRefGoogle Scholar
  10. Heinrich, J., Gehring, U., Douwes, J., et al. (2001). Pets and vermin are associated with high endotoxin levels in house dust. Clin Exp Allergy, 31(12), 1839–1845.PubMedCrossRefGoogle Scholar
  11. Janson, C., Anto, J., Burney, P., et al. (2001). The european community respiratory health survey: what are the main results so far? European community respiratory health Survey II. Eur Respir J, 18(3), 598–611.PubMedCrossRefGoogle Scholar
  12. Karlsson, A.S., Hedren, M., Almqvist, C., et al. (2002). Evaluation of Petri dish sampling for assessment of cat allergen in airborne dust. Allergy, 57(2), 164–168.PubMedCrossRefGoogle Scholar
  13. Kim, J.L., Elfman, L., Mi, Y., et al. (2005). Current asthma and respiratory symptoms among pupils in relation to dietary factors and allergens in the school environment. Indoor Air, 15(3), 170–182.PubMedCrossRefGoogle Scholar
  14. Ko, F.W., Tam, W., Wong, T.W., et al. (2007). Effects of air pollution on asthma hospitalization rates in different age groups in Hong Kong. Clin Exp Allergy, 37(9), 1312–1319.PubMedCrossRefGoogle Scholar
  15. Leung, T.F., Wong, G.W., (2008). The Asian side of asthma and allergy. Current Opinion Allergy Clinical Immunology, 8(5), 384–390.CrossRefGoogle Scholar
  16. Liu, A. H., 2002. Endotoxin exposure in allergy and asthma: Reconciling a paradox. J Journal of Allergy and Clinical Immunology, 109(3), 379–392.CrossRefGoogle Scholar
  17. Mi, Y.H., Norback, D., Tao, J., et al. (2006). Current asthma and respiratory symptoms among pupils in Shanghai, China: Influence of building ventilation, nitrogen dioxide, ozone, and formaldehyde in classrooms. Indoor Air, 16(6), 454–464.PubMedCrossRefGoogle Scholar
  18. Norback, D., Mi, Y.H., Larsson, L., et al. (2002). Current asthma, respiratory infections and hypersennesitivity oft moulds in pupils in Shanghai, China, in relation to microbial components in the classrooms. The 9th International Conference on Indoor Air Quality and Climate, Monterey, California.Google Scholar
  19. Peat, J.K., Dickerson, J., Li, J. (1998). Effects of damp and mould in the home on respiratory health: a review of the literature. Allergy, 53(2), 120–128.PubMedCrossRefGoogle Scholar
  20. Radon, K. (2006). The two sides of the “endotoxin coin”. Occup Environ Med, 63(1), 73–78, 10.PubMedCrossRefGoogle Scholar
  21. Saraf, A., Larsson, L., Burge, H., et al. (1997). Quantification of ergosterol and 3-hydroxy fatty acids in settled house dust by gas chromatography-mass spectrometry: comparison with fungal culture and determination of endotoxin by a Limulus amebocyte lysate assay. Appl Environ Microbiol, 63(7), 2554–2559.PubMedGoogle Scholar
  22. Simpson, A., Custovic, A. (2005). Pets and the development of allergic sensitization. Curr Allergy Asthma Report, 5(3), 212–220.CrossRefGoogle Scholar
  23. Smedje, G., Norback, D. (2001). Irritants and allergens at school in relation to furnishings and cleaning. Indoor Air, 11(2), 127–133.PubMedCrossRefGoogle Scholar
  24. Smedje, G., Norback, D., Edling, C. (1997). Asthma among secondary schoolchildren in relation to the school environment. Clin Exp Allergy, 27(11), 1270–1278.PubMedCrossRefGoogle Scholar
  25. Sporik, R., Chapman, M.D., Platts-Mills, T.A. (1992). House dust mite exposure as a cause of asthma. Clin Exp Allergy, 22(10), 897–906.PubMedCrossRefGoogle Scholar
  26. Sundell, J., Zuber, A. (1996). Ozone and other photochemical oxidants in ambient and indoor air—properties, sources and concentrations. Scand J Work Environ Health, 22 (Suppl 3), 5–14.PubMedGoogle Scholar
  27. van Strien, R.T., Engel, R., Holst, O., et al. (2004). Microbial exposure of rural school children, as assessed by levels of N-acetyl-muramic acid in mattress dust, and its association with respiratory health. J Allergy Clin Immunol, 113(5), 860–867.PubMedCrossRefGoogle Scholar
  28. von Hertzen, L., Haahtela, T. (2006). Disconnection of man and the soil: reason for the asthma and atopy epidemic? J Allergy Clinical Immunol, 117(2), 334–344.CrossRefGoogle Scholar
  29. Watts, J. (2006). Doctors blame air pollution for China’s asthma increases. Lancet, 368(9537), 719–720.PubMedCrossRefGoogle Scholar
  30. WHO, W.H.O. (2005). WHO air quality guidelines global updata.Google Scholar
  31. Wilkins, C.K., Clausen, P.A., Wolkoff, P., et al. (2001). Formation of strong airway irritants in mixtures of isoprene/ozone and isoprene/ozone/nitrogen dioxide. Environ Health Perspect, 109(9), 937–941.PubMedCrossRefGoogle Scholar
  32. Wong, G.W., Leung, T.F., Ko, F.W., et al. (2004). Declining asthma prevalence in Hong Kong Chinese schoolchildren. Clinical land Experimental Allergy, 34(10), 1550–1555.CrossRefGoogle Scholar
  33. Zhang, J.J., Hu, W., Wei, F., et al. (2002). Children’s respiratory morbidity prevalence in relation to air pollution in four Chinese cities. Environ Health Perspect, 110(9), 961–967.PubMedCrossRefGoogle Scholar
  34. Zhao, J., Ma, Y., Chen, Y.Z., et al. (2003). Prevalence of allergic respiratory disorders and skin prick test in Beijing urban and suburban children: A comparative study. Zhonghua Yi Xue Za Zhi, 83(21), 1879–1881.PubMedGoogle Scholar
  35. Zhao, Z. H., Elfman, L., Wang, Z.H., et al. (2006). A comparative study of asthma, pollen, cat and dog allergy among pupils and allergen levels in schools in Taiyuan city, China and Uppsala, Sweden. Indoor Air, 16(6), 404–413.PubMedCrossRefGoogle Scholar
  36. Zhao, Z., Zhang, Z., Wang, Z., et al. (2008). Asthmatic symptoms among pupils in relation to winter indoor and outdoor air pollution in schools in Taiyuan, China. Environment Health Perspective, 116(1), 90–97.CrossRefGoogle Scholar

Copyright information

© Zhejiang University Press, Hangzhou and Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  • Zhuo-Hui Zhao
    • 1
  • Zhuan-Hua Wang
    • 2
  • Zheng Zhang
    • 2
  • D. Norbäck
    • 3
  • G. Wieslander
    • 3
  1. 1.Department of Environmental Health, School of Public Health, Key Laboratory of Public Health Safety, Ministry of EducationFudan UniversityShanghaiChina
  2. 2.Key laboratory of Chemical Biology and Molecular Engineering of Ministry of EducationShanxi UniversityTaiyuanChina
  3. 3.Department of Occupational and Environmental MedicineUniversity Hospital and Uppsala UniversityUppsalaSweden

Personalised recommendations